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Objective <p>To characterize adjacent-level disc radiomic differences and symptom associations in single-level lumbar disc herniation (LDH) on sagittal T2-weighted MRI.</p> Methods <p>This retrospective single-center study included 100 patients with MRI-confirmed single-level LDH. The index herniated disc (Label 1) and cranial adjacent disc (Label 2) were segmented in all patients; the caudal adjacent disc (Label 3) was analyzed when anatomically present and a complete radiomics record was available (<i>n</i> = 68). A total of 107 original PyRadiomics features were extracted per ROI. Paired Wilcoxon signed-rank tests with Benjamini-Hochberg false discovery rate correction were used for Label 1 vs. Label 2, Label 1 vs. Label 3, and Label 2 vs. Label 3. Sensitivity analyses excluded shape features, repeated Label 1 vs. Label 2 in complete three-level cases, stratified by index level, and compared index with non-index discs at the same anatomical level. Symptom associations were assessed using Spearman and partial Spearman analyses.</p> Results <p>Pfirrmann grades differed across available levels in complete three-level cases (median [IQR]: 3 [2–3], 2 [2–2], and 2 [2–3] for Labels 1–3; Friedman <i>p</i> &lt; 0.0001). Radiomics identified 71, 86, and 47 significant features for the three paired comparisons, respectively. Substantial non-shape differences remained after excluding shape features (59/93, 75/93, and 34/93 significant features). A non-shape summary score (PC1) at the index level was associated with VAS (rho = 0.49) and ODI (rho = 0.41), with similar adjusted results.</p> Conclusion <p>MRI-based radiomics provides complementary quantitative disc phenotyping in single-level LDH, revealing robust adjacent-level differences and moderate cross-sectional symptom associations. Longitudinal evaluation and external validation are required before prognostic use.</p>

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MRI-based radiomics reveals disc-level radiomic heterogeneity and is associated with symptom severity in single-level lumbar disc herniation

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • Machao Guo,
  • Xianhua Cai,
  • Zhangjia Xie,
  • Peng Cui,
  • Shibao Lu

摘要

Objective

To characterize adjacent-level disc radiomic differences and symptom associations in single-level lumbar disc herniation (LDH) on sagittal T2-weighted MRI.

Methods

This retrospective single-center study included 100 patients with MRI-confirmed single-level LDH. The index herniated disc (Label 1) and cranial adjacent disc (Label 2) were segmented in all patients; the caudal adjacent disc (Label 3) was analyzed when anatomically present and a complete radiomics record was available (n = 68). A total of 107 original PyRadiomics features were extracted per ROI. Paired Wilcoxon signed-rank tests with Benjamini-Hochberg false discovery rate correction were used for Label 1 vs. Label 2, Label 1 vs. Label 3, and Label 2 vs. Label 3. Sensitivity analyses excluded shape features, repeated Label 1 vs. Label 2 in complete three-level cases, stratified by index level, and compared index with non-index discs at the same anatomical level. Symptom associations were assessed using Spearman and partial Spearman analyses.

Results

Pfirrmann grades differed across available levels in complete three-level cases (median [IQR]: 3 [2–3], 2 [2–2], and 2 [2–3] for Labels 1–3; Friedman p < 0.0001). Radiomics identified 71, 86, and 47 significant features for the three paired comparisons, respectively. Substantial non-shape differences remained after excluding shape features (59/93, 75/93, and 34/93 significant features). A non-shape summary score (PC1) at the index level was associated with VAS (rho = 0.49) and ODI (rho = 0.41), with similar adjusted results.

Conclusion

MRI-based radiomics provides complementary quantitative disc phenotyping in single-level LDH, revealing robust adjacent-level differences and moderate cross-sectional symptom associations. Longitudinal evaluation and external validation are required before prognostic use.